Fungating Squamous Cell Carcinoma

SavageGlow · #1 ● 12-05-2024, 09:04 PM

A 45-year-old, African male, presented to the urology unit with a large, foul-smelling scrotal ulcer. The ulcer had dramatically increased in size and severity during the preceding four months. He had been diagnosed with HIV five years earlier. Despite antiretroviral therapy treatment being initiated timeously, he had been known to have defaulted on numerous occasions. His current viral load and CD4 count was 826 copies/mL and 33 cells/uL, respectively. Clinically, the patient appeared chronically ill, wasted and cachectic with a foul-smelling, fungating, ulcerating, and locally destructive mass with rolled edges involving most of his scrotum, the base of the penis and pubic bone . Also, he had bilateral palpable inguinal lymph nodes, with large fixed nodes in the left inguinal region. Blood work on admission revealed a low haemoglobin (9.6 g/dL), normal renal and liver function tests. Urine specimen and wound swab for culture was negative. A punch biopsy of the scrotal lesion confirmed invasive moderately differentiated focally keratinising SCC. The further metastatic evaluation confirmed the presence of metastatic, large para-aortic lymphadenopathy. Palliative, cisplatin-based chemoradiotherapy was initiated. The patient, unfortunately, demised two months after the first presentation.